Sleep Disorders Association Research Articles

Association of sleep disorders with non-lab-based CVD risk score among Indian population aged above 45 years: insight from Longitudinal Aging Study in India

Background: Both sleep disorders and cardiovascular events have been found to increase with age. The current study aimed to find an association between the two. Methods: The current analysis used data from Longitudinal Aging Study in India (LASI) (1st) conducted from April 2017 to December 2018 with sleep disorder as the output variable. Non-lab-based CVD risk score, defined by the WHO (2019) was explanatory variable. Possible confounders were also included in the secondary analysis. Results: Sleep disorder was seen among 11.69%, higher in females, elderly >60 years, rural population, unemployed and those with limited physical activity and self-reported poor health. Increased CVD risk score was associated with higher odds of having sleep disorder [5-9: 1.19 (1.12-1.28), 10-19: 1.31 (1.22-1.40), 20-29: 1.24 (1.09-1.41)]. On stratified analysis, similar results were seen in males but showed higher odds in the highest risk score category in females. Conclusions: Recognition and management of sleep disorders, especially those with cardiovascular comorbidities and risk factors is important.

Associations of sleep disorders with serum neurofilament light chain levels in Parkinson’s disease

BackgroundSleep disorders are a prevalent non-motor symptom of Parkinson’s disease (PD), although reliable biological markers are presently lacking.ObjectivesTo explore the associations between sleep disorders and serum neurofilament light chain (NfL) levels in individuals with prodromal and early PD.MethodsThe study contained 1113 participants, including 585 early PD individuals, 353 prodromal PD individuals, and 175 healthy controls (HCs). The correlations between sleep disorders (including rapid eye movement sleep behavior disorder (RBD) and excessive daytime sleepiness (EDS)) and serum NfL levels were researched using multiple linear regression models and linear mixed-effects models. We further investigated the correlations between the rates of changes in daytime sleepiness and serum NfL levels using multiple linear regression models.ResultsIn baseline analysis, early and prodromal PD individuals who manifested specific behaviors of RBD showed significantly higher levels of serum NfL. Specifically, early PD individuals who experienced nocturnal dream behaviors (β = 0.033; P = 0.042) and movements of arms or legs during sleep (β = 0.027; P = 0.049) showed significantly higher serum NfL levels. For prodromal PD individuals, serum NfL levels were significantly higher in individuals suffering from disturbed sleep (β = 0.038; P = 0.026). Our longitudinal findings support these baseline associations. Serum NfL levels showed an upward trend in early PD individuals who had a higher total RBDSQ score (β = 0.002; P = 0.011) or who were considered as probable RBD (β = 0.012; P = 0.009) or who exhibited behaviors on several sub-items of the RBDSQ. In addition, early PD individuals who had a high total ESS score (β = 0.001; P = 0.012) or who were regarded to have EDS (β = 0.013; P = 0.007) or who exhibited daytime sleepiness in several conditions had a trend toward higher serum NfL levels.ConclusionSleep disorders correlate with higher serum NfL, suggesting a link to PD neuronal damage. Early identification of sleep disorders and NfL monitoring are pivotal in detecting at-risk PD patients promptly, allowing for timely intervention. Regular monitoring of NfL levels holds promise for tracking both sleep disorders and disease progression, potentially emerging as a biomarker for evaluating treatment outcomes.

Investigation of Common Pathways and Putative Biomarker Candidates of Colorectal Cancer and Insomnia by Using Integrative In-Silico Approaches.

Colorectal cancer (CRC) is one of the leading causes of cancer-related mortalities across the globe. Accumulating evidence shows that individuals having sleep disorders such as insomnia are at high risk of developing CRC, yet the association of sleep disorders with CRC risk is still unclear. Here, we investigated the potential molecular connections between CRC and insomnia using integrative in silico approaches. This study aims to explore the potential molecular connections between CRC and insomnia utilizing integrative in-silico methodologies. Gene expression microarray datasets for CRC and insomnia samples were retrieved from the NCBI-GEO database and analyzed using R. Functional enrichment analysis of common differentially expressed genes (DEGs) was performed by the g: Profiler tool. Cytoscape software was used to construct a protein-protein interaction network and hub gene identification. Expression profiles of hub genes in TCGA datasets were also determined, and predicted miRNAs targeting hub genes were analyzed by miRNA target prediction tools. Our results revealed a total of 113 shared DEGs between the CRC and insomnia datasets. Six genes (HSP8A, GAPDH, HSP90AA1, EEF1G, RPS6, and RPLP0), which were also differently expressed in TCGA datasets, were prioritized as hub genes and were found to be enriched in pathways related to protein synthesis. hsa-miR-324-3p, hsa-miR-769-3p, and hsa-miR-16-5p were identified as promising miRNA biomarkers for two diseases. Our in-silico analysis provides promising evidence of the molecular link between CRC and insomnia and highlights multiple potential molecular biomarkers and pathways. Validation of the results by wet lab work can be utilized for novel translational and precision medicine applications to alleviate the public health burden of CRC.

Associations of sleep disorders with all-cause MCI/dementia and different types of dementia - clinical evidence, potential pathomechanisms and treatment options: A narrative review.

Due to worldwide demographic change, the number of older persons in the population is increasing. Aging is accompanied by changes of sleep structure, deposition of beta-amyloid (Aß) and tau proteins and vascular changes and can turn into mild cognitive impairment (MCI) as well as dementia. Sleep disorders are discussed both as a risk factor for and as a consequence of MCI/dementia. Cross-sectional and longitudinal population-based as well as case-control studies revealed sleep disorders, especially sleep-disorderded breathing (SDB) and excessive or insufficient sleep durations, as risk factors for all-cause MCI/dementia. Regarding different dementia types, SDB was especially associated with vascular dementia while insomnia/insufficient sleep was related to an increased risk of Alzheimer's disease (AD). Scarce and still inconsistent evidence suggests that therapy of sleep disorders, especially continuous positive airway pressure (CPAP) in SDB, can improve cognition in patients with sleep disorders with and without comorbid dementia and delay onset of MCI/dementia in patients with sleep disorders without previous cognitive impairment. Regarding potential pathomechanisms via which sleep disorders lead to MCI/dementia, disturbed sleep, chronic sleep deficit and SDB can impair glymphatic clearance of beta-amyloid (Aß) and tau which lead to amyloid deposition and tau aggregation resulting in changes of brain structures responsible for cognition. Orexins are discussed to modulate sleep and Aß pathology. Their diurnal fluctuation is suppressed by sleep fragmentation and the expression suppressed at the point of hippocampal atrophy, contributing to the progression of dementia. Additionally, sleep disorders can lead to an increased vascular risk profile and vascular changes such as inflammation, endothelial dysfunction and atherosclerosis which can foster neurodegenerative pathology. There is ample evidence indicating that changes of sleep structure in aging persons can lead to dementia and also evidence that therapy of sleep disorder can improve cognition. Therefore, sleep disorders should be identified and treated early.

Association of sleep disorder with cardiovascular risk in the Chilean adult population

Background: sleep disorder can be considered as a relevant factor in patients with cardiovascular risk.Objective: the main objective of this study is to associate sleep disorder as a determining factor for the decrease or increase in cardiovascular risk in the adult population.Methods: transversal analytical study based on secondary records obtained from the database of the third National Health Survey from 2016-2017, with a total of 6 233 respondents aged 15 years and over, through a random and complex selection (stratified and multistage by conglomerates). Data from the Epworth Scale and cardiovascular risk classification were used. Binary logistic regression was applied with the R 3.2.2 “svy” package.Results: a statistically significant association was found between high cardiovascular risk and Epworth scores between 11-21 points (compared with 0-10 points) adjusted for sex and age (ß= 0,63; p=0,002).Conclusion: there is observational evidence that allows associating the sleep disorder with a higher risk of developing and / or dying from cardiovascular disease in the Chilean adult population

Gender Modulated the Association of Sleep Apnea and Sleep Duration with Arterial Stiffness: The ELSA-Brasil Study.

Increased arterial stiffness is independently associated with cardiovascular risk. Obstructive sleep apnea (OSA) and sleep duration (SDUR) may contribute to increased arterial stiffness, but it is unclear whether this association is modulated by gender. We aimed to evaluate the potential impact of gender in modulating the association of OSA and SDUR with arterial stiffness. Participants from the ELSA-Brasil study performed sleep assessments with portable polygraph to define OSA severity and SDUR by 1-week wrist actigraphy. Pulse wave velocity (PWV) was measured using a standard technique without access to the sleep data. We studied 1863 participants (42.2% male, age: 49±8 years, respiratory disturbance index (RDI): 9.9 (4.5-19.4) events/h, SDUR: 6.5 (5.9-7.1) hours, mean PWV: 7.3 ± 1.2 m/s). We found that men had higher PWV, higher frequency of diabetes, and higher blood pressure when compared to women. The regression analysis showed an independent association between increased RDI and PWV in men (ß: 0.007; 95% CI: 0.001-0.012), but not in women. In contrast, an independent association between SDUR and increased arterial stiffness was observed only in women (ß: 0.068; 95% CI: 0.002-0.134). In conclusion, the association of sleep disorders with arterial stiffness showed a distinct gender pattern depending on the sleep variable studied.

Association of sleep disorders with asthma: a meta-analysis

BackgroundAnimal experiments and clinical trials have revealed a potential relationship between sleep disorders and asthma. However, the associations between these factors remain unclear.Material and methodsWe searched PubMed, Embase, Web of...

Association of sleep disorders with clinical symptoms and age in Chinese older adult patients with and without cognitive decline.

To investigate correlation between cognitive function, age, and sleep disturbances. This retrospective clinical study enrolled 78 patients with sleep disorders who were divided into three groups: a group of 24 patients with sleep disorders accompanied by cognitive decline (SD-CD); 54 patients with sleep disorders and no cognitive decline (SD-nCD) was divided into two groups, one of 30 patients aged between 60 and 70 years and another of 24 patients aged >70 years. Polysomnography was used to record patients' sleep indicators throughout night; these included total sleep duration, sleep efficiency (SE), sleep latency, sleep structure and percentage of N1, N2, and N3 stages, rapid eye movement (REM) stage, as well as apnea hypopnea index (AHI), and oxygen saturation (OS). Analysis of variance (ANOVA) for continuous variables and chi-square test for categorical variables were used to analyze variables between different groups. Pearson's correlation was used to analyze correlation between sleep parameters and mini-mental state examination (MMSE). Blood samples were used to determine their Aβ, Aβ40, Aβ42, total tau, phosphorylated tau protein (ptau), ptau181, ptau217, the inflammatory factor IL-1β, vitamin B12 (VB12), and melatonin levels. In the SD-CD group, there was a significant decrease in SE and an increase in N1 stage sleep in older patients and a significant increase in AHI, REM stage AHI, and non-REM stage AHI. In patients with SD-nCD, the minimum OS, minimum OS in the REM period, and minimum OS in the non-REM period were significantly reduced. OS was significantly correlated with cognitive level, as evaluated by the MMSE. The addition of sleep parameters can significantly improve the accuracy of dementia diagnosis. Dementia biomarkers of Aβ and tau proteins in blood showed cognition-related differences, while ptau181 was associated with both cognition and age-related differences. Regression models revealed that age was related to higher levels of cognitive decline before (β = -0.43, P < 0.001) and after (β = -0.38, P < 0.001) adjustment of gender, BMI, and education level. There was a significant mediation effect of relationship between aging and cognitive function by sleep efficiency and N1 stage sleep. Sleep disorders and low OS are associated with a higher incidence of cognitive decline and dementia.

Association of sleep disorders with various polymorphic variants of the 5-HTTLPR SNP rs25531 A&gt;G gene in people aged 25–44

Objective : to study the associations between polymorphic variants of the 5-HTTLPR SNP rs25531 A&gt;G gene and sleep disorders in the open population of the able-bodied population aged 25–44 years in Novosibirsk. Material and methods . A representative sample of the population aged 25–44 years in Novosibirsk was surveyed in 2013–2016 (403 men, mean age – 34±0.4 years, response – 71%; 531 women, mean age – 35±0.4 years, response – 72%). The general examination, included in the WHO MONICA-psychosocial (MOPSY) program was carried out according to standard methods. Sleep disturbance was assessed using the Jenkins scale. Three hundred forty nine (349) people who underwent genotyping were selected from the total sample using the method of random numbers generation. Results . In the studied population aged 25–44 years, 42.8% of respondents gave a negative assessment of their sleep, 39.7% of men and 45.3% of women had sleep disorders (χ 2 =11.397; df=4; p&lt;0.05). In 19.6% of men and 21.5% of women, sleep duration was 6 hours per day, 5.7% of men and 4.5% of women reported 5 hours of sleep per day (χ 2 =2.269; df=5; p&gt;0.05). The most common genotype of the 5-HTTLPR SNP rs25531 A&gt;G gene was SL A (43.3%), L A L A (26.4%) was on the second place, SS (17.8%) was on the third place, less represented genotypes in our population were L A L G (6.9%), SL G (4.4%), L G L G (1.4%) genotypes. Among individuals with the SL A genotype more common was 5–6 hour sleep (55.3%) (χ 2 =4.121; df=1; p&lt;0.05) and 8–10 hour sleep (63.5%) (OR=4.863; 95% CI 1.625–14.555; χ 2 =7.625; df=1; p&lt;0.01), among L A L A carriers – 8–10 hour sleep (58.5%) (χ 2 =4.862; df=1; p&lt; 0.05), compared with carriers of the L A L G genotype, among whom 7-hour sleep was more common (73.7%). Conclusion . The effect of the 5-HTTLPR SNP rs25531 A&gt;G gene on serotonin neurotransmission contributes significantly to the etiology of sleep disorders.

Bridging the Gap between Psychiatry and Neurology: Alzheimer's disease- symptoms beyond memory impairment

It is increasingly recognized that there is significant heterogeneity in phenotype and clinical trajectories in Alzheimer's disease.Up to 25% of Alzheimer's disease (AD) cases do not show the typical neuropathology. Recently subtypes and atypical non-amnestic AD presentations have been formalized in the International Working Group (IWG) clinical diagnosis criteria. Clinical diagnosis of atypical AD has significantly been improved by the availability of biomarkers, including cerebrospinal fluid levels of Aβ42, total tau (t-tau) and phosphorylated tau181 (p-tau), MRI volumetric estimation of hippocampal and medial temporal atrophy, and amyloid brain PET imaging. Special attention will be given to language variant of Alzheimer's disease. A predominant deficit in the language domain is a key feature of primary progressive aphasia but language impairment is commonly present in Alzheimer's disease. International diagnostic criteria for PPA and its three variants (agrammatic, logopenic, semantic) were published in 2011. Since then, studies have investigated the validity of these criteria in classifying patients which includes clinical symptoms, neurocognitive presentations, distinct MRI signatures, and neuropathological differences. In this session special attention will be given of logopenic PPA a syndrome frequently seen in atypical Alzheimer's disease. Even though Alzheimer's disease is most notable for memory impairment, language impairments are also found early in the disease course. Indeed, neuropsychological testing shows changes in confrontation naming and semantic fluency. However, there is an additional body of research that shows that changes in spontaneous language, including idea density, speech quantity, fluency, and tempo can differentiate between normal aging and Alzheimer's disease.A physiologic sleep pattern is essential in the process of memory formation. Inadequate sleep results in cognitive impairment. MCI has an increased rate of sleeping problems compared to healthy people of the same age. In MCI, primary sleep disorders like sleep-disordered breathing, PLMS, RLS, RBD are more common, and also associated with a high rate of progression from MCI to AD. MCI also showed shorter total sleep time (longer in non-amnestic MCI), sleep efficiency, and cyclic alternating pattern. There is increased nighttime behavior. EEG power in amnestic MCI showed a reduction in the power of delta and theta frequency. There is a reduction in fast spindle counts on frontal location. Blunted and delayed onset with a duration of REM sleep reduced. A growing body of evidence supports the hypothesis that people with sleep disorders have a higher risk of developing Alzheimer's disease AD. Insomnia, self-reported sleep disturbances, decline in sleep duration, impaired sleep consolidation, delayed or decreased circadian rhythms and sleep-disordered breathing have been shown to increase AD risk, supporting the hypothesis that a chronically disrupted sleep-wake cycle can drive AD pathogenesis. Associations of sleep disorders and neurodegeneration in Alzheimer's are complex. Its understanding however is crucial for proper AD prevention, diagnosis, as well as management.Psychosis is a core syndrome in other than Alzheimer's disease and neurodegenerative disorders. It is however present in a large percentage of patients with AD. Psychosis most commonly presents as a delusional process and is linked to disruptive behavior, rapid progression, and overall morbidity. Psychotic syndromes in AD are complex but necessary to be diagnosed and managed properly.

Abstract HUP20: Association Of Sleep Disorders And Mortality Among Stroke Survivors: Are There Disparities By Race/ethnicity?

Background and Rationale: Sleep disorders are associated with increased mortality among stroke survivors. Although minority groups are disproportionally affected by stroke, it remains unclear if there are race/ethnic differences in association between sleep disorders and mortality among stroke survivors. Methods: Using the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2014, we examined the association between sleep disorder (doctor’s diagnosis as well as positive answer to question “ever told doctor you have trouble sleeping) and cardiovascular and all-cause mortality stratified by race/ethnicity (non-Hispanic White, Black, Mexican American, other Hispanic, other race/ethnicity) in adult patients (≥18 years) with a self-reported history of stroke. The first model was adjusted for sociodemographic variables (age, sex, level of education, and income). The second model further adjusted for clinical variables (body mass index and history of coronary artery disease, myocardial infarction, hypertension, diabetes, and cancer). Results: Out of total of 1045 stroke survivors, 443 (42.4%) had sleep disorders, including 44.3% (Standard error-SE: 2.8%) of non-Hispanic White individuals, 43.6% (SE: 3.6%) of Black individuals, 41.6% (SE: 3.5%) of Mexican Americans, 46.6% (SE: 8.6%) of other Hispanic individuals, and 47.6% (SE: 7.4%) of other races. There were no significant relationships between race/ethnicity and the presence of sleep disorders in any of the models. Overall, the presence of sleep disorders was associated with higher all-cause mortality in model 1 (Hazard Ratio, HR: 1.69, 95% confidence interval, CI: 1.11-2.43) and model 2 (HR: 1.71, 95%CI: 1.13-2.59). There were no significant associations between sleep disorders and cardiovascular mortality. There were no significant interactions between race/ethnicity and outcomes (all-cause and cardiovascular mortality). Conclusion: In this nationally representative sample of stroke survivors, nearly half had a history of sleep disorder. Sleep disorders were independently associated with all-cause mortality, but there were no race/ethnic differences in prevalence or outcomes.

Sleep Disorders and Attention-Deficit/ Hyperactivity Disorder in Children: A HospitalBased Observational Study from a Regional Early Intervention Centre in Kerala, India

Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is one of the most extensively studied neurobehavioural disorders of childhood. The association of sleep disorders with ADHD is multidimensional, and understanding them is important in effectively managing patients with ADHD. Aim: To examine the presence of sleep disorders in children with ADHD, to correlate it with parameters of age and ADHD subtypes, and to find out the association between sleep disorders and other socio-demographic, and clinical factors. Materials and Methods: The study sample of this hospitalbased observational study consisted of 70 subjects who presented to the Regional Early Intervention Centre (REIC), Thrissur, diagnosed with ADHD based on DSM 5 criteria and belonging to the age group 5-16 years. Subjects were interviewed using a structured questionnaire to assess sociodemographic and clinical details. The ‘Sleep Disturbance Scale for Children’ (SDS-C) was used to assess sleep disorders in children. The information thus obtained was analysed using SPSS software version 23. Results: Out of the 70 subjects with ADHD, 49 (70%) had sleep disorders. The mean age of study population was 8.66±2.72 years, and the male:female ratio was 4:1. There was comorbid behavioural disorder in 32 subjects (45.7%), and parental history of ADHD in 33 subjects (47.1%). There was a significant association between sleep disorders and behavioural disorders (p-value=0.003) and parental history of ADHD (p-value=0.042). There was a significant negative correlation between age and sleep disorder (p-value=0.033). Conclusion: The prevalence of sleep disorders in ADHD is high in the study population. The relationship between sleep disorders and the presence of comorbid behavioural disorders in ADHD suggests that recognition and management of sleep disorders may require more attention. The association between sleep disorder and parental history of ADHD may enhance the understanding of genomic variants associated with ADHD.

Is there any association between sleep disorder and temporomandibular joint dysfunction in adults? – A systematic review

ABSTRACT Objective To answer the question, “Is there any association between sleep disorder and temporomandibular joint dysfunction (TMD) in adults?” Methods This study followed PRISMA guidelines and was registered in PROSPERO. As eligibility criteria, observational studies that evaluated the association between sleep disorder and TMD were included. Exclusion criteria included a) studies that evaluated sleep quality and not the association of sleep disorders with TMD, b) experimental studies, book chapters, conference proceedings, and systematic reviews. The Joanna Briggs Institute tool was used to assess the risk of bias. Results In the literature search, 3425 articles were found. After the exclusion of duplicates, 2752 were selected for reading the title and abstract, of which 26 were read in full, and 18 met eligibility criteria. Conclusion The association of sleep bruxism with TMD is controversial. While, for obstructive sleep apnea, insomnia, snoring, and gastroesophageal reflux, the analyzed studies showed a positive association.

Associations of Sleep Disorders With Depressive Symptoms in Early and Prodromal Parkinson's Disease.

BackgroundNon-motor symptoms, including sleep disorders and depression, are common in Parkinson’s disease (PD). The purpose of our study is to explore the effect of sleep disorders, including the probable rapid eye movement (REM) sleep behavior disorder (pRBD) and the daytime sleepiness, on depressive symptoms in patients with early and prodromal PD.MethodsA total of 683 participants who obtained from the Parkinson Progression Markers Initiative (PPMI) were included, consisting of 423 individuals with early PD, 64 individuals with prodromal PD, and 196 healthy controls (HCs), who were followed up to 5 years from baseline. Multiple linear regression models and linear mixed-effects models were conducted to explore the relationship between sleep disorders and depression at baseline and longitudinally, respectively. Multiple linear regression models were used to further investigate the association between the change rates of daytime sleepiness score and depression-related score. Mediation analyses were also performed.ResultsAt baseline analysis, individuals with early and prodromal PD, who had higher RBD screening questionnaire (RBDSQ) score, or who were considered as pRBD, or who manifested specific behaviors of RBD (things falling down when sleep or disturbance of sleep), showed significantly the higher score of depression-related questionnaires. Our 5-year follow-up study showed that sleep disorders, including pRBD and daytime sleepiness, were associated with the increased depressive-related score in individuals with early and prodromal PD. Interestingly, we also found that the increased possibilities of daytime sleepiness were associated with depressive-related score. Finally, mediation analysis demonstrated that the relationship between RBD and depressive symptoms was partially mediated by autonomic symptoms, such as postural hypertension, salivation, dysphagia, and constipation.ConclusionOur study shows that sleep disorders, including pRBD and daytime sleepiness, are associated with depression at baseline and longitudinally, which is partially mediated by the autonomic dysfunction in early and prodromal PD, with an implication that sleep management is of great value for disease surveillance.

Association of Sleep Disorders and Socio-demographic Characteristics in Patients with Depressive Disorder

Objectives: To assess the pattern of sleep and the correlation with socio demographic parameters in patients with depressive disorder. Study Design: Descriptive cross sectional study. Study Setting and Duration: A psychiatric consultation clinic in Karachi from January 2015 till December 2019. Methodology: Patients between ages of 18 and 60 years, irrespective of gender were included in the study. Patients with florid psychotic symptoms, dementia and chronic debilitating medical illness such as chronic renal or liver failure were excluded. Pattern of sleep was categorized as patients with normal sleep (sound sleep of 7-9 hours), insomnia and hypersomnia. Diagnosis of Insomnia and hypersomnia was made according to ICD – criteria. Results: The mean age of patients was 30.89 (10.256) years. Age was significantly associated with the pattern of sleep among depressed patients. Younger patients between the ages of 18-35 years more frequently suffered from insomnia while the older patients (35-65 years) were more frequently experiencing hypersomnia (p=0.01). The majority of the patients who were either separated or divorced experienced hypersomnia, 15 (71.4%) however, the difference was not statistically significant (p=0.582). The most common psychiatric comorbidity among patients was obsession compulsion disorder (OCD) with a frequency of 225 (39.4%) followed by anxiety disorders; 100 (17.5%). Conclusion: Our study indicates that sleep patterns are significantly challenged in depression patients. The younger population was more prone towards insomnia while the older patients more frequently had hypersomnia. Further large scale studies are needed to explore the risk factors associated with the sleep disturbance and the role normal sleep patterns play in recovery of depressed patients. Keywords: Psychiatry, Depression, Insomnia, Hypersomnia, Dementia

794 Contribution of sleep disorders to dementia incidence following traumatic brain injury: A decade-long retrospective cohort study

Abstract Introduction We aimed to examine the association between sleep disorders and dementia risk in a population-based cohort of adult male and female patients with traumatic brain injury (TBI). Methods We studied a province-wide retrospective cohort of all adult patients (≥ 18 years) free of dementia at the admission to the emergency department or acute care hospital with diagnoses of TBI between May 2003 and April 2013. All patients were followed through until May 2016. The primary exposure was a sleep disorder, and the primary outcome was dementia, both defined by the International Classification of Diseases, tenth revision diagnosis. Associations of sleep disorders with dementia were analyzed in multivariate Cox Proportional Hazard modeling. Results In total, 712,708 patients with TBI of all severities were included in this study. Their median age was 44 years, 59% were males. Over a median follow-up of 52 months (interquartile range, 19–86 months), 32,834 (4.6%) developed dementia. Controlling for age, sex, income level, injury severity, and known comorbidity risks, diagnosed sleep disorder was a significant predictor of incident dementia: hazard ratio (HR), 1.250 [95% CI, 1.146–1.363]. When results were stratified by sex, the association of sleep disorder with dementia remained significant in male: HR 1.255 [95% CI, 1.112–1.415] and in female patients: HR 1.234 [95% CI, 1.088–1.400]. Sensitivity analyses on Alzheimer’s disease case definition and using Fine and Gray competing risk models confirmed the association between sleep disorder and dementia in both sexes. Conclusion In both sexes, sleep disorders were independently associated with dementia onset (adjusted HRs&amp;gt;1.2). Thus, screening for sleep disorders should be part of regular care for TBI patients, as with the steady increase of TBI survivorship and life expectancy, undiagnosed sleep disorders can initiate a new cascade of cognitive deficits independent from TBI. Support (if any) This work was supported by the postdoctoral research grant from the Alzheimer’s Association (AARF-16-442937) to T.Mollayeva. The authors were also supported by the Eunice Kennedy Shriver National Institute of Child Health &amp; Human Development of the National Institutes of Health under Award Number R21HD089106 and the Canadian Institutes for Health Research Grant–Institute for Gender and Health (#CGW-126580).

Association of sleep disorders with subfoveal choroidal thickness in preschool children

ObjectiveTo explore the association between sleep disorders and subfoveal choroidal thickness (SFCT) in preschool children.MethodsIn this population-based cross-sectional study, children aged 60–72 months were measured for SFCT using spectral-domain optical coherence tomography (SD-OCT) and for sleep disorders using the Chinese version of Children’s Sleep Habits Questionnaire (CSHQ). Multiple linear regression analyses were performed to assess the association between sleep disorders and SFCT.ResultsA total of 1337 children (mean (SD) age: 66.88 (3.41) months) were included in the analyses. In multivariable linear analysis, a higher total CSHQ score (indicating higher likelihood of sleep disorders) was associated with a thinner subfoveal choroid (beta, −0.070; 95% CI, −0.141 to −0.001; P = 0.046). When each of eight CSHQ subscale scores was analysed by the multivariable model, only the Daytime Sleepiness subscale score was negatively associated with the SFCT (beta, −0.115; 95% CI, −0.183 to −0.046; P = 0.001). The children with clinically significant daytime sleepiness (n = 364, 27.2%) had significantly thinner subfoveal choroid than other children (295.47 vs. 308.52 μm, P = 0.007).ConclusionsOnly daytime sleepiness was significantly associated with SFCT in preschool children in this study. The potential relationship between sleep disorders during childhood and children’s ocular development needs further research.

Association of Sleep Disorder on Motor Function of Pre-School and School-aged Cerebral Palsy Children in a Tertiary Rehabilitation Centre of Eastern Zone, India

Association of Sleep Disorder on Motor Function of Pre-School and School-aged Cerebral Palsy Children in a Tertiary Rehabilitation Centre of Eastern Zone, India

Sleep Disorders in Patients with Psoriatic Arthritis

Sleep disorders are currently a major public health issue in Brazil, due to its high incidence and difficult diagnosis, identification of type and treatment.1 Rheumatic disorders have been associated with changes in sleep state, which cause reduction in quality of life, eventually reduced by the chronic inflammatory process of the primary disease.2–6 This study aimed to identify and describe the existence of sleep disturbances in patients with psoriatic arthritis, as well as to verify possible association of sleep disorders with metabolic syndrome and other parameters in these individuals. Thirty one patients with psoriatic arthritis from a Rheumatology Outpatient Clinic were analyzed. Three sleep assessment questionnaires were employed: Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (EPW) and The Berlin Questionnaire (BQ). Sleep walking or talking were also inquired as a complementary scale. Sociodemographic variables and the presence of hypertension, obesity, diabetes, dyslipidemia and metabolic syndrome have also been investigated. On average, sleep disorders were found in 54.83% of the studied patients (64.5% from PSQI, 51.6% from EPW and 48.4% from Berlin) and around 70% of sleep disorders in patients with simultaneous diagnosis of metabolic syndrome and psoriatic arthritis. From these results, it is notable that sleep disorders are common in patients diagnosed with psoriatic arthritis. Thus, this pathology demands greater attention in clinical practice and search for ideal and complete therapy, in addition to simultaneous control of arthritis, sleep, hypertension, dyslipidemia and obesity.

Association of Sleep Disorders With Physician Burnout

This cross-sectional study evaluates the association between sleep disorders and burnout symptoms among faculty and staff at a large teaching hospital.